Most
patients who suffer from essential arterial hypertension must be treated with a
antihypertensive preparation in order to adequately control blood pressure.
According to current ESH (European Society of Hypertension)/ESC (European
Society of Cardiology) guidelines, physician have at their disposal five main
groups of antihypertensives (as also referred to as basic antihypertensives)
for use in either monotherapy or in combination: diuretics, beta-blockers (BB),
calcium ion channel blockers (CaI), angiotensin convertase (ACE) inhibitors and
sartans.
Basic
antihypertensives possess very similar efficacies in terms of blood pressure
reduction. When used at full dose, the average drop of systolic blood pressure(SBP) is 9.1 mm Hg and diastolic blood pressure (DBP) 5.5 mm Hg. However,
before the initiation of pharmacotherapy, other co-morbidities ,
contraindications and other factors must be taken into consideration.
Considering the guidelines, initiation with renin-angiotensin-aldosterone
system (RAAS) inhibitors i.e. ACE inhibitors or sartans is mostly recommended
for a majority of co-morbidities. Alpha-1 blockers should only be considered in
resistant hypertension, if no contraindication exists. Methyldopa (an alpha-2
agonist) should be preferred in hypertensive pregnant women. Read more............
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